It’s rush hour in Pittsburgh, and Doctor Barry Kerzin is 15 stories above Downtown and the local share of a deeply unhappy American workforce scurrying below.
Kerzin, the longtime personal physician for His Holiness the 14th Dalai Lama, arrived in town hours earlier from Dharamsala, the community of Tibetans in-exile in northern India where Kerzin, a native of California, has lived in residence with the spiritual leader for three decades now.
He’d come to Pittsburgh, as he has for several years, to teach thousands of UPMC nurses how to relax. In a profession known for its high burnout rate, Kerzin sees an acute need for coping strategies and mechanisms central to the Buddhist faith.
But seated in the Omni William Penn Hotel in his kashaya robe, Kerzin was clear that we could all probably benefit from unwinding a bit.
The American workforce is statistically and verifiably miserable. Stress levels among American workers have climbed 20 percent over the last three decades, and a 2018 Gallup poll found that 23 percent of employees reported feeling burned out at work very often or always. In short, we are in the midst of a burnout epidemic with significant economic implications.
But Kerzin insists there’s a way to break the cycle, and he’s come to Pittsburgh to tell health care professionals how. (Police, gang members, and even you could be next, he explains.)
So, when we caught up with Kerzin on Tuesday morning, we asked him what we needed to do to set our happiness free. We also asked for his readings on Pittsburgh’s spiritual health, Mayor Bill Peduto’s spiritual health, and the eternal struggle for that elusive work-life balance.
The conversation has been edited for clarity and length.
Dr. Kerzin, why am I so unhappy?
We’ve got to relax more. We’ve got to smile or we’ve got to slow down a little bit. You know, the more speedy and, you know, tight and serious we become — we have natural happiness inside of us, and all that stuff just puts it in jail, right? We gotta unlock the jail by smiling more and being a little more relaxed.
Slow down and connect with nature. There are parks around here that are lovely. Go spend a couple hours in the park. All that stuff, I think, helps. If you want to go a little bit further than that, then you start working on yourself.
What does that mean, working on yourself?
You start to learn how to be introspective, how to look and see what’s happening. What am I thinking? What am I feeling right now? And then work with it. Don’t be afraid when negative stuff pops up because we’re all filled with positive and negative stuff. Just ask, ‘How can I gently work with it without beating myself up?’
Is this what you’re teaching the nurses at UPMC?
This is my sixth trip to Pittsburgh. And I’m invited primarily by UPMC, by the health plan. And we’ve been working extensively with UPMC nurses, and we’ll continue that on this visit. There are 16,000 UPMC nurses, and we’ve finished about 2,500. Our plan is to train all 16,000 in resilience, compassion, and mindfulness, or at least a big chunk of them.
On this trip, we’re going out to one of the satellites in Altoona. We’ll be working with the nurses there and in the surrounding area.
What does that look like?
First, I give a talk. I show slides and we laugh a lot. And then we cry a lot. And we do a little meditation together.
We teach them to recognize, you know, the early signs of anger, jealousy, pride. And when you train yourself, you start noticing these things and then you can apply the antidote. We’re teaching them methods to identify these (emotions) early and then to transform, to change it into their positive opposites. The positive opposite of anger is tolerance and patience. The positive opposite of jealousy is appreciation. And the positive opposite of pride or arrogance is humility.
And of course, it doesn’t work overnight. But we’ve gotten incredible feedback. (Kerzin conducts similar sessions with workers in health systems across the country and globe through his nonprofit Altruism in Medicine Institute.)
Are there any other groups that you’ve identified as being particularly in need of this approach? And I’d like to personally recommend journalists.
I believe in open and free journalism. I’d be happy to work with you. Teachers are another group, and we do a lot of work with teachers.
And Mayor Bill Peduto, who I’m having dinner with tomorrow night, one of the projects he’s mentioned he’d like me to get involved with is working with the law enforcement leaders in Pittsburgh and maybe western Pennsylvania.
Would your work with police be similar to your work with nurses?
The burnout issues with nurses are not the same as with law enforcement officers. So we’ll be targeting, you know, the needs that (police) have. And I’ll be meeting, hopefully on this trip, with Pittsburgh Police Chief Scott Schubert to outline some of the specific needs they have, and we’ll address them. Now, the way we address them will be in a similar fashion. But the target and needs will be a little different from those two groups, nurses and law enforcement officials.
And the other thing that we’re going to be talking about on this visit — we won’t be doing it this time but will be setting it up for November’s visit — is working with some of the gang leaders in Pittsburgh. I’ve asked Bill (Strickland) at the Manchester Bidwell Corporation to help coordinate that. We’re also working with Richard Garland. He’s a professor at Pitt who was in prison for 20 years and now he’s working to try to turn around some of the poverty issues and the violence in the community.
What are your impressions of Pittsburgh? Does it strike you as a particularly spiritual place?
One of the reasons I keep coming back is the people. I’d never been to Pittsburgh and, quite frankly, I never wanted to come to Pittsburgh, you know. And then I was invited here and I was blown away.
I mean, the work UPMC is doing — be it gender issues, ethnic issues, economic issues, you name it, they’re really doing a lot of work. They’re sincere and from the heart. And this made me think, ‘Wow, there’s something good happening here.’ To me, that’s spiritual.
Spiritual is not necessarily just going to church and praying to God. A spiritual experience is walking the walk. And that’s what keeps me coming back. Having said that, the place is beautiful. It’s just a beautiful city.
Would it be fair to say that anybody working in the American economy could probably benefit from more mindfulness, more resilience, more compassion?
I think the answer is yes. I wouldn’t push it down anybody’s throat. It has to be pretty much voluntary. You can’t force this on anybody. But for those that are interested, the answer is yes.
What other ways can employees avoid or treat burnout? Should we be working fewer hours?
We can reduce hours, but that’s not easy to do. The data has got to convince the people making the decisions that by reducing hours it’s going to improve the productivity and they’re not going to lose money.
A better economic argument comes from the National Academy of Medicine. They published some data that says if a doctor burns out and leaves the profession, it costs half a million dollars to replace that doctor. And it’s something similar for a nurse.
You’ve talked before about the difference between empathy and compassion. Can you elaborate?
Empathy is wonderful stuff. It opens our heart. But it also makes us vulnerable to burnout. Because, you know, literally, it’s stepping in the other person’s shoes. And if the other person is hurting, which they often are in the healthcare sector, then there’s a tendency to adopt or own that other person’s pain.
And if we keep doing that, it just builds up and then it’s too much and we burnout. And so how can we move beyond empathy, keeping our hearts open, but not taking on the pain of others. That’s compassion.
You helped arrange Mayor Peduto’s visit with the Dalai Lama in March. Does Peduto strike you as someone who is resilient, compassionate, mindful?
I think so, yes. He’s very bright. He seems to be well liked. Pretty much everybody I talk to says he’s great. And, you know, could he use more resilience, compassion and mindfulness? Yeah. Could I use more? Sure. But I think he’s doing a fantastic job.
What’s it like living in Dharamsala? And how does it compare to an American city like Pittsburgh?
Apples and oranges. It’s in the foothills of the Himalayas. (The city’s population is an estimated 50,000.)
For Tibetan refugees living in India, most of them are scattered in the rural areas throughout India, and most of them are in southern India, but their headquarters are in Dharamsala. And their exiled government resides there in Dharamsala, and His Holiness the Dalai Lama lives there in Dharamsala.
It’s getting busier now. The one road is getting sort of crowded with taxis. When I first went there, there were zero taxis. And now there’s probably 100 or more on one road, the only road.
But in the springtime, like now, we have the natural flower in the area. It’s a Rhododendron tree. Their flowers are bright red. And this time of year they drop their flowers, you know. And so there are parts around where we live where you can walk and the footpaths are like red velvet. It’s really beautiful.
Years ago, researchers at the University of Wisconsin, Madison, studied your brain and the impacts of meditation. What did they find?
With me? Nothing. There was nothing in between my ears. They were amazed I was still alive. No.
They studied long-term meditators, and they defined long-term by, you know, having more than 10,000 hours of meditation experience. Some people had 60,000 hours. So, they looked at about 11 or 12 of us over a couple of years. And the question they sought to answer was are the brains of long-term meditators the same or different from other people’s?
And they found better attention skills in long-term meditators. In the functional MRI, they found that the prefrontal cortex — it’s called the executive function center because it regulates higher levels of cognition, things like planning, imagination, innovation, creativity, compassion — was not only anatomically bigger in long-term meditators but by the functional blood flow studies it was more active.
How can everyday people integrate compassion and meditation into their own lives? How should they start?
Morning is the best time. Your mind is generally more clear, unless you had the late shift.
Pick a place in your home that’s the least chaotic. I know everybody’s home is chaotic, but pick the least chaotic place and just tell everybody else, ‘Please don’t bug me for five minutes or 10 minutes.’ You don’t need to set an alarm. But just do it every day.
You can sit on a chair or a cushion, but your back should be straight. And, you know, it’s a little like running when you become a runner. You do it every day, or pretty much every day, you develop endorphins and you feel good. And if you don’t do it, you’re missing something. It gets to be the same way.
You know, a lot of times we go to bed thinking we had a lousy day, right? But if you put some of the compassion, even a smile and some kindness, a few things like that in your day, you know, you’re more likely to go to bed thinking, okay, maybe it was a lousy day but there was a little bit of meaning there. It felt good.